100 Years of Compassionate Care: RMH School of Nursing Makes a Transition

By the early 1960s, the nursing staff consisted of 23 administrative personnel, 62 medical floor nurses, 8 nursing teaching faculty and more than 80 student nurses. An indication of the success of the RMH School of Nursing was the fact that nearly 80 percent of the nurses employed by the hospital were graduates of the nursing program.

Under the ever-watchful supervision of Miss Virginia Reilly and nursing education director Marian Jameson, the education RMH nurses received was outstanding and often was considered to be superior to that offered by many other nursing schools. Bobbie Baugher Horne, class of 1962, recalled that when she was hired at Riverside Hospital in the Newport News area, the other nurses she worked with were amazed at the variety of procedures she was familiar with.

"My training was superior and gave me self-confidence in handling all types of situations,'" she said. "'m sure that's why I was selected as a member of the hospital team that visited Johns Hopkins in 1962 to learn about their Intensive Care Unit, which was one of the first.

Mary Ann Burner, '61, also found that RMH Nursing School graduates were recognized as outstanding nurses by her administrators when she worked at Saint Elizabeth's Hospital and the Children's Hospital in Washington, D.C. "Students from our school were always chosen to do the private duty on the sickest and most critically ill persons," she said. "We were considered the best trained and had the most floor experience.

This was a direct reflection of the diligence and leadership of Miss Reilly and her team of administrative assistants and nurse instructors. Many students recalled Miss Mae Bontz, the night shift supervisor, for her kindness, experience and medical knowledge. Others credited Miss Elanor Glick as an instructor who had a great deal of influence on their personal growth and instilled a constant devotion to care of their patients. Margene Moore, '43, remembered a situation that illustrated Miss Bontz' years of nursing experience:

"One time when I was on 1st South night duty, I had a patient who was scheduled to go home that day at 6 a.m. I took her temperature and it was 101 degrees. I called Miss Bontz and I'll never forget her standing at the door of the patient's room and saying, 'I can tell you from here what is wrong.' Then she walked to the patient, opened her abdominal dressing, and pus was covering the incision. She could smell it.

During the early 1960s, one of the problems faced by the nursing administrators, nurses and student nurses was the stress of constant overcrowding of the hospital. Patients were often placed in beds in hallways, waiting until a room could be provided. This meant nurses had to carry equipment - if it was available - and medication to the hallways to care for the patients. Sanitary conditions were also much harder to maintain in the hallways.

Miss Reilly recognized the result of this situation, reporting to the board that, "Consistently functioning to capacity in the Medical and Surgical units and frequently overflowing into examining, waiting rooms and halls accounted for many of our problems.

Morale of both patients and staff suffered from the overcrowding, which was made worse by the fact that young student nurses were not always available to help. The freshman student nurses had full academic loads and were in class or studying for most of each day. Senior student nurses were often gone on six-month training courses at other hospitals.

One positive result of this situation, however, was that young nurses got thrown into real-world nursing situations very quickly and learned to handle this responsibility. They also gained experience in treating sick and injured patients that could not be learned from a book or in a classroom situation. This proved valuable to many of them later in their careers.

Betty McCoy graduated from the RMH School of Nursing and went on to serve as an assistant director of nursing services under Miss Reilly.

Betty McCoy remembered that, as a young nursing student, "Of course, we were supervised by an RN, but we were essentially in charge of the units. If an emergency came in during the night or a woman was brought to the hospital in labor, we provided all their care until a doctor could get to the hospital, which sometimes could be a long time."

She noted that this was before there was an established emergency room, and primary care was given right on the unit.

After the nursing school became accredited, the student nurses did not perform as much service on the floors and their place had to be taken by full-time regular nurses.7

The unavailability of nursing students to help with patients put additional strain on staffing. As a result, the nurses' aides became more and more valuable to the hospital, which began to conduct training classes for nurses' aides so they could help reduce the workload on the medical nurses. This proved to be only a stopgap solution and failed to prevent a higher than desirable turnover rate among floor nurses.

Hospital growth and the increasing number of patients resulted in other changes as well. The heavy administrative demands placed upon Miss Reilly, in addition to her responsibility for the Nursing School, caused the Board to make a change in the administrative structure in 1967. It had become apparent that one person could not manage both the medical nursing service and the nursing school. The Board voted to hire an administrator to take over the nursing school, allowing Miss Reilly to devote her time entirely to the administration of the nursing service.

Miss Marian Jameson, after earning her masters degree in Nursing Administration from the University of Maryland-Baltimore, was hired as RMH Director of Nursing Education. She continued in that position until 1972, when Miss Reilly retired. At that time she was promoted to the position of Director of Nursing Services, and Betty McCoy, an assistant director under Miss Reilly, temporarily took over the administrative duties until a replacement was found for Miss Jameson. When Miss Margaret Snyder was hired for the position as Director of Student Nursing, Miss Jameson was able to turn over the education of young nurses to Miss Snyder and take up her new position as the Director of Nursing Services.

Along with new nursing leadership came more changes. "One thing that changed from what was done in the old days was that in the past, nurses were expected to stand up when a doctor came into the room,"McCoy said. "Nursing routine and regulations during that time often followed almost military rules because many of the old-time nurses of that day had been in the Army or Navy during World War II or served later during the Korean War.

Miss Virginia Reilly, with hospital administrator J. Nelson Liskey, greets guests during her retirement reception in 1972, after 30 years of service and leadership at RMH.

Audrey Zirkle Gayhart, '47, remembered daily inspections held at 6:30 a.m. by Miss Reilly, during which the nurses ready to go on duty had to stand in ranks with pressed white uniform, polished white shoes, and hair off the collar.9

Although there were many changes in nursing, some things stayed the same - at least for awhile. Until the 1960s, at RMH, the required nursing attire was a white, heavily starched uniform, white nurse's cap and white shoes. The only jewelry allowed while on duty was a wedding ring.

Other, more important changes in the field of nursing were on the horizon that would directly affect the Nursing School. These changes would not be met with approval by many at RMH.

Not long into Miss Jameson's tenure as Nursing Director, it became apparent to her, as well as hospital administration, that the national trend in nursing education was slowly but steadily changing. It was moving away from nursing diploma schools toward nursing degree programs at colleges and universities. As a result, the Trustees eventually came to a decision that spelled the end of the nursing school at RMH.

"The feeling was that our three-year diploma school should become a four-year program, in cooperation with Madison College (later to become James Madison University)," Miss Reilly stated.10 The RMH Board agreed with her. The school's closing was never about quality because it was clear that nurses educated at RMH received an excellent nursing education that was head and shoulders above that offered by many other schools. The change was brought about, for the most part, by the changes in educational expectations.

"Nursing was changing, and so were students' expectations. Parents wanted their child to have a degree, not a diploma," Liskey noted.11

Miss Jameson also found that receiving accreditation from the National League for Nursing was becoming more and more difficult due to constantly changing academic requirements and standards. She repeatedly had to modify her educational programs to meet the standards and challenges of modern nursing as required by the national organization.

In 1972, reflecting the national trend away from nursing diploma schools, the RMH Board of Trustees appointed a committee to discuss the transfer of the nursing school to Madison College. The changeover was initially expected to be complete by 1973, but this proved to be overly optimistic. The transfer of the nursing program took three more years to complete.

On January 28, 1976, the RMH School of Nursing, after graduating 1,010 nurses since 1912, closed its doors, ending a tradition of educational excellence at the hospital.

Class of 1977: Due to numerous challenges, including ever-changing academic requirements and standards to meet school accreditation, the RMH School of Nursing closed to new students in January 1976, graduating its last class in 1977. The nursing program was transferred to James Madison University and became a four-year degree program rather than a three-year diploma program